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Russell Patrick Jackson
Medical Physician Assistant in Casa Grande, Arizona
NPI 1699322578

Russell Patrick Jackson is a Medical Physician Assistant based in Mesa, AZ and is specialized in Medical. Russell Patrick Jackson practices in Casa Grande, AZ. The NPI Number for Russell Patrick Jackson is 1699322578 and holds a License No. (Arizona).

The current practice location address for Russell Patrick Jackson is 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ and can be reached out via phone at 602-569-3999 and via fax at 520-340-4359. You can also correspond with Russell Patrick Jackson through the mailing address at 7311 E SOUTHERN AVE APT 3064, MESA, AZ - 85209-2723 (mailing address contact number: ).

Location: 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ, 85209-2723
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699322578
Provider Name
Russell Patrick Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ, 85209-2723
Phone Number
602-569-3999
Fax Number
520-340-4359
Provider Enumeration Date
08/24/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
301 E Cottonwood Ln Ste 1&2
City
Casa Grande
State
Arizona
Zip
85122-2551
Phone Number
602-569-3999
Fax Number
520-340-4359
person
Provider Business Mailing Address Details
Address
7311 E Southern Ave Apt 3064
City
Mesa
State
Arizona
Zip
85209-2723
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
8654 (Arizona)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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